by Prakash Tyagi, Executive Director, GRAVIS
Despite rapid economic growth in recent years, India's health indicators continue to be dismal. Based on rankings of health systems and per capita expenditure on health, India trails way behind other countries even though it's one of the 10 largest economies in the world. India ranked 112th out of 190 countries in the World Health Organization's 2000 report and 154th out of 195 countries in the Lancet's Global Burden of Disease Study. A geographically large, densely populated, and culturally diverse country, India's public health challenges are particularly complex. But if we are to move forward on the path to Universal Health Care, they must be addressed.
A key trend that will affect India's healthcare landscape is population aging. The number of older people in India is growing rapidly. 104 million older people live in India, 75% of whom live in rural areas where access to quality healthcare is often limited. Older people in India are also more likely to be living in poverty. The poverty rate among India's older population is 80% and accompanied by malnutrition and poor health.
Gender inequality, another pressing problem, has a cumulative impact in older age. The challenges of older women are compounded by the intersecting forces of gender-based discrimination and ageism. Older women, in particular, also have extremely high illiteracy rates, which only adds to their vulnerability and dependence on family members.
GRAVIS, an affiliate of HelpAge, has taken up several initiatives to demonstrate quality, cost-effective, and replicable healthcare in some of the most challenging parts of India. The aging population is at the fore-front of our public health vision and strategies. GRAVIS health interventions for older people focus on three critical components. First, we provide accessible primary and secondary care services and outpatient services. With a team of only 30 staff, the hospital GRAVIS independently runs is able to serve 2,000 people every month.
Second, we provide local communities with education on healthy aging. Specifically, we facilitate self-care trainings for older people and their caregivers, trainings for health workers and NGO staff working in the region. Third, GRAVIS focuses on community-based needs assessments, documentation of best practices, and advocacy for innovation and replicable models. Part of our outreach involves specific attention to making sure we reach older women, widows and older people living with disabilities. In the Thar Desert region of India, GRAVIS reaches out to nearly 100,000 older people with its medical, public health and advocacy interventions.
For World Health Day, GRAVIS organized five major rallies and conventions in the Thar Desert. Over 1,000 older people participated in these events to demand greater inclusion in healthcare programs and policies. Together we are calling for public and private sector action that includes older people and their specific needs. By 2050, the population of people age 60 and over will triple to 324 million; 48 million will be over the age of 80. With such a significant demographic shift, true progress on healthcare is not possible if older people can't access it. Universal healthcare in India can only be realized if there is a holistic and time-bound plan to bridge the service delivery gaps and speed up the pace of education, training and capacity-building interventions. With our strong community network-our hospitals, community health workers, and older person's associations-GRAVIS is working to improve public health from the ground up and fill in these gaps in healthcare.
GRAVIS is a HelpAge affiliate in India, working to empower marginalized people through integrated rural development. GRAVIS initiatives provide health care, sanitation, and water and food security to some of the most impoverished regions in Rajasthan, Uttarakhand, and Uttar Pradesh. In 2017, GRAVIS expanded its successful models into Africa, establishing partnerships in Kenya and Malawi to apply its water harvesting technologies.